| NPI | 1902519663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA HUDGINS Owner 907-531-0585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2022-12-27 |